BACKGROUND:The stress changes of bone are the main simulation sources for bone remodeling. At present, the research on the relationship between stress and bone remodeling focuses on the effect of axial stress on bone remodeling, while the research on bone remodeling under bending force is rare.
OBJECTIVE:To observe the bone remodeling of rabbit tibia diaphysis cortical bone in growth phase under bending force.
METHODS:A bone window with the diameter of 2.5 mm was made 0.5 cm from the medial distal epiphyseal line of rabbit proximal left tibia, and then ice saline was used to cool the tibia and memory al oy film. After cooling, the memory al oy stripe was straightened and implanted into the tibial bone marrow cavity through the bone window. The direction of memory al oy stripe implantation:two ends of the memory al oy stripe arrived to the lateral cortex after rewarming, and the curve apex arrived to the medial cortical bone, fol owed by the sutured wound. The continuous internal bending force was loaded on the rabbit tibia diaphysis through the shape memory al oy stripe implanted into the tibial bone marrow cavity in order to observe the bone remodeling mode of tibia diaphysis cortical bone under long-term bending force.
RESULTS AND CONCLUSION:After 6 months continuous bending force, the thickness of cortical bone on the tension stress side of tibia diaphysis was decreased, while the thickness on the compressive stress side was increased, and no obvious bending deformation was observed. The thickness of the cortical bone on the compressive stress side was associated with the stress distribution on tibia. The tibia with integrity structure exhibited an inherent“resistance”to the bending stress, this indicating that the bone shaft of the long bone without fracture had no potential of force line correction basical y. The results suggested that the bone remodeling model of tibia diaphysis cortical bone had the advantages of less trauma, control ed force, less influence on the growth and metabolism, no limitation on the animal activities and meet the physiological state, which was an ideal model of bone remodeling.

This paper analyzes library users' satisfaction about service quality of the library of Peking University School and Hospital of Stomatology.The main factors associated with users' satisfaction are discussed.In the end,it proposes a series of effective measures to promot library service quality.

Objective To compare the effects of intra-sinus thrombolysis by using urokinase and heparin anticoagulation alone for cerebral venous sinus thrombosis (CVST).Methods Consecutive inpatients with CVST were enrolled retrospectively.Their demographic and clinical data were collected.The treatment mainly consists of intra-sinus thrombolysis by using urokinase and heparin anticoagulation alone.The outcomes were evaluated according to the modified Rankin scale (mRS) at 6 months.The mRS score ＜ 2 was defined as good outcome,and ≥2 was defined as poor outcome.Results A total of 36 patients were enrolled,including intra-sinus thrombolysis by using urokinase (n =18) and heparin anticoagulation alone (n =18).Twenty-one had good outcomes and 15 had poor outcomes.After treatment,the recanalization rate (94.4％ vs.66.7％ ;x2 =3.850,P=0.041) of the urokinase thrombolysis group and the good outcome rate at 6 months (72.2％ vs.44.4％ ; x2 =3.827,P =0.046) were significantly higher than those of the heparin anticoagulation group.The proportion of the patients receiving intra-sinus thrombolysis by using urokinase of the good outcome group was significantly higher than that of the heparin anticoagulation group (60.0％ vs.18.2 ％ ; x2 =5.360,P =0.021).Multivariate logistic regression analysis showed that the intrasinus thrombolysis by using urokinase was an independent protective factor for good outcomes in patients with CVST (odds ratio,1.085,95％ confidence interval 1.024-1.361; P=0.023),and the high coagulation state was its independent risk factor (odds ratio,0.185,95％ confidence interval 0.049-0.611;P=0.004).None of the patients occurred symptomatic cerebral hemorrhage.Conclusions Intra-sinus thrombolysis with urokinase may improve the outcomes for patients with CVST,and it is superior to the heparin anticoagulation alone.

Objective This study aimed to discuss the different assessment of pain among medical and nursing staff and cancer patients and supply reference for proper analgesic precept for clinical application and nursing measures. Methods We collected the assessment of psychological pain and physiological pain by 55 hospitalization cancer patients, 40 physicians in-charge and 55 nurses in-charge in one week by Johnson inventory. The assessment results were compared and at the same time the relevant problems of the attitude to cancer pain by patients was also investigated. Results Improper recognition existed in cancer pain treatment by most cancer patients. The physiological pain was higher than the psychological pain assessed by both patients and nurses (P<0.05). But the pain assessment by patients was higher than that by the nurses (P<0.05). The assessment of psychological pain was higher than the physiological pain by doctors and both aspects were lower than those by patients, but no statistical difference was seen (P>0.05). The assessment by doctors was more accurate than that by nurses. Conclusions Routine establishment of pain assessment inventory for patients could instruct patients how to record the degree of their pain. We should strengthen the standard training about pain management knowledge and give timely communication with patients' cancer pain.

Objective To establish a kind of medical box for wound debriding and change dressing in sanitary train,which could be used to satisfy the requirements of natural and manmade disasters for medical service.Methods With tri-grade modularization theory,the medical box were divided into four functional sections,including disinfection cleaning solution section,debriding and change dressings common section,contaminated wound change dressings section and infected wound change dressing section.Through the four sections,the medical box could be provided 5 wound debirding and 50 change dressings.Results The medical box can satisfy all requirements for wound treatment with useful and convenient function.Conclusions The invented medical urgent box has so many advantages of modularization,complete functions and expansionary,which could satisfy all requirements for sanitary train.

This paper explored the educational reform of dispensing Chinese drugherbs. The education reform included implementing the project of teaching methods, implementing modern experimental methods, cultivating comprehensive quality of students, training students' creative thinking, and stimulating the initiative of students. All these strategies could improve the quality of teaching and make students' comprehensive abilities meet the demand.

Objective To explore clinical feasibility of liver transplant from child of brain death to adult, to summarize the clinical experiences that a child of brain death transplants liver to an adult. Methods The recipient was a 39-year-old woman patient with primary hepatic carcinoma and posthepatitis cirrhosis (decompensation stage); while the donor was a 8-old-year child of brain death because of brain neoplasms. Donated liver was gained by the method of en bloc multivisceral procurement in a short time; the operative method was classic orthotopic liver transplantation. The postoperative managements included immunosuppression, prevention of infection, hepatic protection, and other relevant supports etc. Results The transplantation operative duration was 6 hours, after which not only did the recipient survive but also her body functioned well including the liver part, with no severe postoperative complications. Conclusions The technology of transplanting livers from children to adults is feasible. The key to ensure the success of transplant operation is systematic preoperative evaluation, excellent operative technique, and perfect postoperative treatment.

Anesthesiology rotation is an important part in resident standardization training of surgery. However, there are many problems in the teaching process. For example, the key points of teaching is not clear, the process of teaching is not coherent, and teachers and students lack interaction. The Rotation Record is introduced in order to solve those problems. The Rotation Record effectively reflects the fundamental process and major learning point of anesthesiology department which contains three items: the usage and recording of instrument; the communication and the basic knowledge and operating skills of anesthesia. The Rotation Record can initiate learning activity, emphasize important contents, supervise and urge teaching and improve the learning effect. By introducing Rotation Record, the assessment results in the surgical residency in anesthesiology has greatly improved compared to the previous ones, and has effectively improved the teaching quality of anesthesia.

A 32-year old male who had liver cirrhosis accompanying with chronic renal insufficiency (uremia) was suffered from homochronous allograft transplantation of liver-kidney. The blood and other tissue typing were in concord between the donor and recipient. The liver transplantation took typical orthotopic transplantation technique while the kidney transplantation took general operation method to place the transplanted kidney at the recipient's right lilac fossa. Daclizumab was taken for the immunity induction treatment before transplantation while the trigeminy of tacrolimus+mycophemocate mofeil+methylprednisolone were taken as immunosuppressant after transplantation. The transplanted liver and kidney recovered well which could work at once without any serious complications after transplantation, suggesting that combined liver-kidney transplantation was an effective treatment method for homochronous function failure of liver and kidney characterizing by perfect tissue typing, excellent operation skill, reasonable usage of immunosuppresant being the key point of success for transplantation.

Objective To investigate the safety and efficacy of hepatitis B surface antigen (HBsAg) positivity of the donors on graft survival and liver complications in HBsAg (+) renal transplant recipients.Methods We retrospectively evaluated 96 HBsAg (+) patients who received HBsAg(+) donor kidney transplant fellow-up during 20～ 139 months,in order to observe the renal allograft dysfunction,liver dysfunction and others complications.Results All 96 patients underwent renal transplantation successfully in our hospital.during the follow-up period,18 cases accepted entecavir-treated,one case lost graft function,two cases died,one of them developed drug resistance and liver function failure,the other because of cancer of the liver.Twenty-three of the 78 lamivudinetreated patients (29.5％) developed drug resistance in 7～96 months,and 3 cases developed liver function failure,2 cases died and one cured,15 of the 19 cases who been salvage treated with entecavir was successful and well tolerated after 1 year,2 cases who been salvage treated with adefovir and lamivudine with HBV DNA-negative after 12 months and 23 months.The 5-year patient/graft rates of patients who been treated with lamivudine and entecavir were 88.5％/84.6％ and 88.9％/83.3％ respectively.Conclusion It is safe and feasible for renal transplantation from HBsAg(+) donors to HBsAg(+) recipients with antiviral treatment,patients would require lifelong anti-viral suppression and strictly follow-up,which is important for patient and graft survival,anti-viral drugs resistance and the liver complications should be closely monitored and treated.